Douglas County’s Behavioral Health Court helps those with mental illness break the cycle of incarceration

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Members of Douglas County’s Behavioral Health Court shared how the program has progressed during the past four years and how administrators might further improve the program in the future during a meeting of the Criminal Justice Coordinating Council on Tuesday.

Behavioral Health Court, or BHC, was established to reduce jail time and recidivism for people with mental illness who are charged with a crime. The program seeks to improve participants’ lives through mental health treatment and coordinated support services that address difficulties including substance abuse, lack of housing, and unemployment.

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BHC presiding Judge Sally Pokorny said discussions of such a program began in 2014, but it took two years to garner enough support and funding to start a pilot program in 2016.

“The jail is not the place to treat people with mental illness,” she said. “The jail should not be the hospital for those who are mentally ill. The county commissioners recognized that and have funded behavioral court.”

BHC is open to adult residents of Douglas County who have charges pending against them in municipal or district court. Participants must meet the criteria for having a severe mental illness, and their alleged offenses must be connected in some way to that mental illness. Those charged with homicide, a sexual offense or DUI are not eligible.

Participants move through the program in four phases broken down into smaller pieces focusing on health and stability, treatment, employment and education, and finally plans for maintaining wellness and preventing relapse. The program, which can accommodate up to 25, currently has 20 people enrolled. Pokorny said participants get to know each other and their struggles, triumphs and life stories through the court dockets, and they bond.

One of the greatest challenges to program success is establishing housing, which enables participants to get basic health and medical needs met. As an example, Bert Nash Community Mental Health Center clinician Sharon Zehr mentioned that local public housing programs can’t authorize assistance until criminal charges have been resolved, leaving program participants in housing limbo.

“People who are unhoused have a harder time following through with the requirements of behavioral health court,” Pokorny said. “It’s hard to keep track of your medications and your calendars and your dates if you’re living out of a backpack and … looking for a place to spend the night.”

Data Analyst Matt Cravens detailed statistics showing how the program has evolved during the past four years. Between 2018 and 2020, 62 individuals were accepted into the program and 100 were denied. In 2021, 24 individuals participated in BHC and 37 were denied. Denial occurs for a variety of reasons, most often because a referral doesn’t qualify based on potential public safety risks. Cravens said assessments for program suitability should be made as much as possible based on objective factors rather than a person’s perceived potential for success in the program.

Assistant District Attorney Brian Dieter said the public safety risk rejection could be based either on the nature of the charges a potential participant faces or violence risk appraisal assessments. Douglas County Commission Chair Shannon Portillo asked Dieter if those numbers were also being tracked based on race.

“Risk assessment tools have been heavily criticized for having a number of racial implications that we don’t want to see in these courts,” said Portillo, who also served on the Governor’s Commission on Racial Equity and Justice. “I’d be a little hesitant in thinking about how we use risk assessment in keeping folks out of these types of opportunities.”

Defense attorney Karen Ebmeier said the BHC team was aware of how systemic issues may affect criminal history. She said the team was continually refining its practices to make procedural improvements.

Team members acknowledged that there is still work to do. Cravens specifically pointed to the racial makeup of program participants compared to how those populations fare within the program.

Races and ethnicities of Douglas County Behavioral Health Court referrals, admissions and successful completers. Via Data Analyst Matt Cravens’ report to the Douglas County Criminal Justice Coordinating Council on Jan. 11, 2022.

“The success rate for Black and Native American participants is significantly lower than the success rate for white participants,” he said.

“Among 2018 to 2021 exits, only one of the five Native American participants successfully graduated. I know the BHC team is investigating this disparity further,” he said. “They’re digging into the data, and one idea is perhaps having Haskell folks meet with some Native American participants at some meetings.”

Cravens also pointed out that although Black people make up approximately 39% of the jail residents with serious mental illness, they comprise only 19% of those who are being referred to the program.

He said tracking numbers for the Hispanic population has been inconsistent because identifications are sometimes limited to race and not expanded to include ethnicity.

In 2021, the number of days from first appearance in court to acceptance into the BHC program averaged 121 days. However, according to the National Drug Court Institute, best outcomes are achieved when admission occurs within 50 days.

Overall, post-program analysis showed that 19% of participants who successfully complete the BHC program find themselves back in jail within the following year. For those who exit the program prior to completion, that number jumps to 55%. In addition, those program graduates who do find themselves back in jail stay there on average for only one day, versus 53 days for those who don’t complete the BHC program.

CJCC member Tamara Cash asked what would happen if someone aged 16 or 17 met all the requirements to participate in the program besides age. Pokorny said that her court doesn’t have jurisdiction over juveniles, but establishing a behavioral health court for juvenile offenders could be an excellent idea.

As Pokorny pointed out, while the team continues to make improvements to the program, making changes to anything governmental or court related can feel like trying to turn the Titanic. However, she said, the work is worthwhile and the effects reach beyond the participants.

“These programs have a generational impact on people in our community,” she said. “The family members who come in to support all express their thanks and gratitude because it changes the lives of the children for the better and the lives of parents for better. This will have a giant ripple effect on this community.”

Leonidas the therapy dog is the latest addition to the Douglas County Behavioral Health Court team. “He’s always at the door so that as you leave, you can give Leonidas a pat and he’ll give you the biggest smile you’ve ever seen in your life,” Judge Sally Pokorny said. (Slide from a presentation to the Criminal Justice Coordinating Council on Jan. 11, 2022.)
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Andrea Albright (she/her), reporter, can be reached at aalbright (at) lawrencekstimes (dot) com. Read more of her work for the Times here. Check out her staff bio here.

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